With the implementation of the Affordable Care Act (ACA) and the increased access it provides to health insurance for many previously uninsured people, it’s expected that patient volume in emergency departments (EDs) will continue to increase, driving the need for improved workflow and efficiency.

Likewise, the rising competition among providers to capture that patient volume is getting hotter. One of the key marketing strategies used by hospitals to attract new patients is to upgrade the experience, including in the ED.

The thought is that not only will renovating or expanding the ED lead to shorter wait times but that modern design finishes will communicate that the hospital is on the cutting edge of care.

This trend is driving innovation in architectural design and a renewed focus on patient and staff satisfaction and comfort, creating a front door to a facility that leaves a lasting—and positive—impression.

Some factors and trends affecting ED design today include:

Technology. Imaging, tracking, monitoring, communications, records, and treatment systems are constantly evolving. The result is that many aging EDs simply don’t have the infrastructure to support the technology that patients and doctors demand. This drives major renovations that include upgrades to the IT and electrical system backbone.

Flexible treatment rooms. Designing treatment rooms to be universal rather than specialized allows EDs to better utilize space and maximize throughput. This replaces the traditional model of providing unique specialized rooms for various patient types. However, there are still patient types that need or want special consideration, including bariatric, pediatric, geriatric, or behavioral health patients.

Fast-track. These rooms can add flexibility to an ED by serving low-acuity patients rather than taking up valuable (and now private) bed space. Some EDs report as much as 80 percent of their traffic is represented by relatively minor cases that can be quickly treated and released. When designed similar to standard exam rooms, these spaces can also increase the flex capacity for more acute cases.

Even with these needs identified, the challenge for healthcare facilities is often finding the space to make necessary changes. Remodel and renovation strategies can range from growing the department within the footprint of the hospital by displacing other services, renovating the existing department and expanding outside the perimeter walls, or relocating the department by creating a new wing.

Where possible, the intent is to reduce impact to current services during construction by building in phases.

For a few ideas, see the photo gallery in this blog with images of recently completed and in-progress ED projects.

Nathan A. Murray, AIA, is a principal designer and planner at TSA Architects. He can be reached at nmurray@tsa-usa.com. Douglas L. Banks is senior project architect at TSA Architects. He can be reached at dbanks@tsa-usa.com.